Norotte G, Apoil A, Travers V
Service de Chirurgie Orthopédique et Traumatologique, Hôpital Saint-Antoine, Paris.
Ann Chir Main. 1988;7(4):277-81. doi: 10.1016/s0753-9053(88)80024-3.
Fifty-eight patients (52 males and 6 females) operated on for Dupuytren contracture were examined by the same author with a more than ten year follow-up. At time of surgery the average was 55 years old. 69 hands (169 fingers) rated 4.33 according to the simplified Tubiana's score were treated by the same operative procedure: Mac Indoe's incision, digital Z plasty (if needed), subtotal fasciectomy and physiotherapy beginning 8 days postoperatively. At long term, recurrence appears for 49 hands (71%) one every two in the two first postoperative years, one out of five after five years. 24 of them were graded stage I. The recurrence appeared 14 times associated with an extension of the disease and the earlier, the higher was the initial stage. Some factors seem to be of a bad prognosis regarding recurrence: age (93% of recurrence under 50 years old) Ledderhose or Lapeyronie (100%) other associated diseases (Alcoholism, diabetes mellitus, epilepsy) and severe preoperative stage. Subjective results are good: 45 patients are satisfied and only 3 underwent a second operation.
58例接受Dupuytren挛缩手术的患者(52例男性,6例女性)由同一作者进行检查,随访时间超过10年。手术时患者的平均年龄为55岁。根据简化的图比阿纳评分,对69只手(169个手指)评分为4.33的患者采用相同的手术方法进行治疗:麦金杜切口、手指Z成形术(如有需要)、部分筋膜切除术,并在术后8天开始进行物理治疗。从长期来看,49只手(71%)出现复发,术后头两年每两只手就有一只复发,五年后每五只手有一只复发。其中24只手被评为I期。复发出现了14次,与疾病的扩展相关,且疾病初始阶段越早,复发率越高。一些因素似乎对复发预后不利:年龄(50岁以下复发率为93%)、莱德霍斯病或拉佩罗尼病(100%)、其他相关疾病(酗酒、糖尿病、癫痫)以及术前严重阶段。主观结果良好:45例患者满意,只有3例接受了二次手术。